Russell Medical Clinic

LBN: Russell Medical Clinic
Russell Medical Clinic is an health care organization with primary practice located at 402 Doctors Dr , New Albany MS 38652-3109. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Russell Medical Clinic can be contacted via phone (662) 534-2486, or through Russell, Richard H. via phone (662) 534-2486.

Contact Information

Primary practice address
402 Doctors Dr New Albany MS 38652-3109
Phone: (662) 534-2486
Fax: (662) 534-2839
Website:
Map and Directions
Authorized official contact:
Name: Russell, Richard H. Doctor of Medicine (MD)
Phone: (662) 534-2486

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 208D00000X Mississippi

Profile Details

NPI number 1205024452
LBN Legal business name Russell Medical Clinic
DBA Doing business as
Authorized official Russell, Richard H. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 11th, 2007
Last updated Oct 12th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205024452 NPPES
Mississippi Other C02872 MEDICARE GROUP
Mississippi MEDICAID 09015413 MEDICARE GROUP

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